Temazepam and ativan Taper

For too many reasons to explain, I can only taper off of either Ativan or a combo of Ativan and Temazepam.  Before suggesting a longer acting benzo, these are the ONLY two choices I have (I have liver issues so these are the only safe ones that I can take per a toxicologist, an md and a psych).  I am currently on 3 mg Ativan and 30 mg Temazepam, currently split like this...

1.5 mg Ativan at night

1.5 mg Ativan first thing in the a.m.

15 mg Temazepam  5-7 hours after Ativan

15 mg Temazepam 5-7 hours after last Temazepam

I can use one or the other or a combo of both which is what I'm doing now.  I don't know which one has a longer half life but I think they are pretty close.  Temazepam comes in a capsule (15 mg) which complicates the taper, but I might be able to find a compounding pharmacy to create a liquid suspension so I can titrate slowly.  I already have the ativan in a liquid suspension.

I know this is very specific and kinda complicated, but do you have any suggestions on the best way to taper?

Please help!!

Thank you.

I tapered directly off lorazepam (ativan) and I'm sure you can, too.  It looks like you have already put quite a bit of thought into this, including having the ativan in liquid form and being able to get the temapezam that way as well.  Since you mention a longer acting benzo, I imagine you are familiar with Prof Ashton's method and manual.  She's suggests a beginning taper of 10% of your total dose.  I think you'll want to alternate which dose you reduce and wait 10-14 days between reductions.  You are right that ativan has about the same half-life (10-20 hours) as Temazepam (8-22) but the T. is a much weaker benzo.  For purposes of figuring out how to even out the reductions, 1mg ativan = 10 mg valium = 20 mg Temazepam,  Converting your current schedule to such equivalences, you are taking

1.5mg ativan =      15 mg valium in the pm

1.5mg ativan =      15 mg valium in the am

15 mg temazepam = 7.5 mg  valium 5-7 hours later

15 mg temazepam = 7.5 mg  valium 5-7 hours later

I'd probably start by shaving 10% off one of the ativan doses.  Since you are using liquid ativan, you can draw off/remove the equivalent of .15mg using a syringe I think.  You could talk to your pharmacist about how to do the measurement to get the right amount.  Hope this helps.

I tapered directly off lorazepam (ativan) and I'm sure you can, too.  It looks like you have already put quite a bit of thought into this, including having the ativan in liquid form and being able to get the temapezam that way as well.  Since you mention a longer acting benzo, I imagine you are familiar with Prof Ashton's method and manual.  She's suggests a beginning taper of 10% of your total dose.  I think you'll want to alternate which dose you reduce and wait 10-14 days between reductions.  You are right that ativan has about the same half-life (10-20 hours) as Temazepam (8-22) but the T. is a much weaker benzo.  For purposes of figuring out how to even out the reductions, 1mg ativan = 10 mg valium = 20 mg Temazepam,  Converting your current schedule to such equivalences, you are taking

1.5mg ativan =       15 mg valium in the pm

1.5mg ativan =       15 mg valium in the am

15 mg temazepam = 7.5 mg  valium 5-7 hours later

15 mg temazepam = 7.5 mg  valium 5-7 hours later

 

I'd probably start by shaving 10% off one of the ativan doses.  Since you are using liquid ativan, you can draw off/remove the equivalent of .15mg using a syringe I think.  You could talk to your pharmacist about how to do the measurement to get the right amount.  Hope this helps.

Beeper, since you have a history similar to mine (but yours was for many more years) and you've clearly survived this and I don't want to PM you based on your sig line I have a couple questions.  I know each person is different but 1.  Did you have interdose w/d while on Ativan? 2.  What would you say the duration of your worst w/d s/x were?  Have you reached a point where you feel fairly healthy?  Since I don't know how long you've been off not sure this is a good question to ask, but does one ever feel back to "normal"?

Also, this is directed to anyone with an opinion.  Why would my psych not want me to do c/o to Temazepam entirely?  As I've read it's weaker than Ativan. If I can sleep on Temazepam I would think that would be a benefit.  Are there unique risks associated to Temazepam specifically?

I tapered directly off lorazepam (ativan) and I'm sure you can, too.  It looks like you have already put quite a bit of thought into this, including having the ativan in liquid form and being able to get the temapezam that way as well.  Since you mention a longer acting benzo, I imagine you are familiar with Prof Ashton's method and manual.  She's suggests a beginning taper of 10% of your total dose.  I think you'll want to alternate which dose you reduce and wait 10-14 days between reductions.  You are right that ativan has about the same half-life (10-20 hours) as Temazepam (8-22) but the T. is a much weaker benzo.  For purposes of figuring out how to even out the reductions, 1mg ativan = 10 mg valium = 20 mg Temazepam,  Converting your current schedule to such equivalences, you are taking

1.5mg ativan =       15 mg valium in the pm

1.5mg ativan =       15 mg valium in the am

15 mg temazepam = 7.5 mg  valium 5-7 hours later

15 mg temazepam = 7.5 mg  valium 5-7 hours later

 

I'd probably start by shaving 10% off one of the ativan doses.  Since you are using liquid ativan, you can draw off/remove the equivalent of .15mg using a syringe I think.  You could talk to your pharmacist about how to do the measurement to get the right amount.  Hope this helps.

Beeper, since you have a history similar to mine (but yours was for many more years) and you've clearly survived this and I don't want to PM you based on your sig line I have a couple questions.  I know each person is different but 1.  Did you have interdose w/d while on Ativan?

2.  What would you say the duration of your worst w/d s/x were?  Have you reached a point where you feel fairly healthy?  Since I don't know how long you've been off not sure this is a good question to ask, but does one ever feel back to "normal"?

Not counting the tinnitus which has been going on for 2+ years (and may not be soley due to benzos), I would say it was a tie between full body sweats and blurry vision.  Both lasted for months early on in my taper.  I would say that I've been fairly healthy for more than 2 yeras (my last dose was in July 2008).  I don't remember what my normal was pre-benzo since it was so long ago but I feel normal, whatever that is. 

Also, this is directed to anyone with an opinion.  Why would my psych not want me to do c/o to Temazepam entirely?  As I've read it's weaker than Ativan. If I can sleep on Temazepam I would think that would be a benefit.  Are there unique risks associated to Temazepam specifically?

Hi WWWI, I will follow your progress.  I had been benzo free for 8 months.  Ended up in hospital with cardiac probs and had probably a total of 14mg of IV ativan over 10 days.  They stopped me cold turkey and I seem OK.  I am however, on 15 mg of temaze at night for the last 8 days, which probably eased the ativan c/t.

I think beeper is right to taper the ativan first as temaze is a weaker benzo.  I have HepCv so I understand your concerns as well.  I think I will start a slow-ish temaze taper now that the ativan is gone for 8 days and see what happens.  It is OK if I drop in from time to time and see how you are doing?

My best!  Sky

Yes, I had interdose withdrawal on ativan and finally was dosing 5x/day trying to combat it. 

After your taper, do you remember how long it was before those eased up some? went away?

Also, was there anything that helped with insomnia as you decreased your dosage?

Hi WWWI, I will follow your progress.  I had been benzo free for 8 months.  Ended up in hospital with cardiac probs and had probably a total of 14mg of IV ativan over 10 days.  They stopped me cold turkey and I seem OK.  I am however, on 15 mg of temaze at night for the last 8 days, which probably eased the ativan c/t.

 

I think beeper is right to taper the ativan first as temaze is a weaker benzo.  I have HepCv so I understand your concerns as well.  I think I will start a slow-ish temaze taper now that the ativan is gone for 8 days and see what happens.  It is OK if I drop in from time to time and see how you are doing?

 

My best!  Sky

That's a lot of Ativan, I'm glad the c/t went smoothly.  Sounds like you've been a bit through the mill. You are more than welcome to come by anytime.  I hope the Temazepam taper goes smoothly for you too!